Individual provider Active NPI

Arsen Adjemian, D.D.S.

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1295768430
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2000165880 Issued in MO
Practice address
6410 N Cosby Ave
Kansas City, MO 64151-2377
Phone
(816) 587-2400
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2000165880 MO Primary
General Practice Dentistry 1223G0001X 60241 KS

Addresses

Primary practice location

6410 N Cosby Ave
Kansas City, MO 64151-2377

Mailing address

6410 N Cosby Ave
Kansas City, MO 64151-2377
Phone (816) 587-2400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240506003429 MO Order and Referring Only - DentistPractitioner - Dentist 4880034909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
60241KSMDGeneral Practice Dentistry
2000165880MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Truman Medical Center Incorporated Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295768430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 N COSBY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512377",
            "telephone_number": "816-587-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 N COSBY AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641512377",
            "telephone_number": "816-587-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADJEMIAN",
        "first_name": "ARSEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2000165880",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "60241",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.